Ayurvedic management of immune thrombocytopenic purpura - a case report

Immune thrombocytopenic purpura (ITP) is a bleeding disorder characterized by isolated thrombocytopenia. The course is more chronic in adults associated with higher mortality in older patients. In extreme cases of ITP, serious complications such as bleeding into the lungs, brain, or other vital organs can occur. Clinical manifestations include purpura, petechiae and ecchymosis. Majority of ITP patients are not getting reliable and durable remissions with modern medicine. The present case report deals with an elderly patient having chronic ITP with multiple comorbidities (obesity, schizophrenia, UTI and T2DM) approached for Ayurvedic treatment. Patient came with ecchymotic patches on both upper extremities with extremely low platelet counts (9700/mcL) was diagnosed as Tiryaggata Raktapitta and Ayurvedic treatment has been provided. Ayurvedic formulations (Putapakwa Vishama Jwarantaka Loha, Raktastambhaka Vati, Samshamani Vati etc) have improved the platelet counts (from the lowest count of 9700/mcL to highest count of 50000/mcL), hematological indices and quality of life in present case. Ecchymotic patches were completely disappeared without any further recurrences. The present case of ITP (Raktapitta) is a good example for Nidaanaarthakara Roga as it has manifested due to the consequences of malarial fever (Vishama Jwara). Ayurvedic treatment seems to be promising in the management of chronic ITP and generates hope for those patients who are having extreme thrombocytopenia, multiple comorbidities, reluctant (or unfit) for corticosteroids and invasive diagnostic procedures like bone marrow biopsy, and not satisfied with the available therapy from other systems of medicine. Further clinical trials with large sample size are required to substantiate the present case study findings.